Chronic Disease Management 2.0. Presented in April 2012 at the mHealth conference in Singapore by Callum Bir

1. Client X Disease Management 2.0
Chronic Program A:
Market Opportunity Assessment
Mid-Project Review
Callum Bir
December 2, 2009
Deloitte Consulting, 2012

2. Contents
Chronic Disease Management Burden
Disease Management Operating Model
Australia – Case Study
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3. Nearly half of Americans are expected to have chronic conditions by 2020*
#1 Cause of • Seven out of 10 deaths among Americans
Death each year
• Heart disease, cancer and strokes account
for >50 percent of all deaths each year
4/5 of total • $2 trillion annually by 2009
healthcare cost • expected to increase 6.1 % YoY
• Excl >$200B associated Supervisory Care
Chronic Diseases
• Strain society's capacity to respond to
Capacity health challenges
• Capacity: Beds and Manpower
Life Style / • Many chronic conditions, such as arthritis
Disability (currently the most common cause of
disability), can result in one or more daily
activity limitations

4. Prevalence of chronic condition and attitude towards healthy living or
wellness across 12 selected countries
% Diagnosed with >1 chronic condition % participate in healthy living or wellness program
By Doctor or other medical professional (Past 12 months)
55% U.S. 25%
41% UK 11%
42% Switzerland 9%
51% Portugal 9%
40% Mexico 33%
45% Luxembourg 8%
55% Germany 16%
50% France 9%
41% China 47%
52% Canada 16%
46% Brazil 23%
52% Belgium 12%
60% 50% 40% 30% 20% 10% 0% 0% 10% 20% 30% 40% 50%
Source: Deloitte Health Consumer Survey 2011

5. Patients are generally receptive to help manage their disease
• Nearly 80% of patients with one or more chronic condition are receptive to participating in a health
plan disease management program
• While patients are receptive to disease management only 32% of surveyed patients with a chronic
condition are enrolled in a disease management program, which represents a large potential
opportunity for lower cost interventions with the remaining patients
How Likely Would You Be To Participate in Do You Currently Participate in a
a Health / Disease Management Program? Health / Disease Management Program?
If it cost you nothing to do so
71%76%
/
41%
39%
If it entitled you to reduced insurance costs or a
financial reward
Yes, 32%
21%
19% No, 69%
13% 14%
8% 7%
6% 6%
4% 3% 3% 2% 5% 4%
2% 1% 2% 1%
1 2 3 4 5 6 7 8 9 10
Not at all likely Extremely likely
n = 2,192 respondents with one or more chronic conditions n = 2,192 respondents with one or more chronic conditions
Deloitte's 2009 Survey of Health Care Deloitte's 2009 Survey of Health Care Consumers

6. Chronic Care Delivery Models
• Planned, systematic approach
• Focus to information and self-management needs of
patients
• Multi-disciplinary teams from teams of physicians, nurses,
social workers, aides, and others Chronic Care
Delivery
• Extensive coordination required across settings and Model
clinicians, and over time
• Timely access to clinical information is critical
• Lifestyle related **

7. Traditional Health Care Service Delivery Model:
GP Hospitals Allied Health Polyclinic
Pharmacies Preventative
Care
Coordination of
Care
Business Model
Outcome Based Sustainability
Incentives Strategic
Partnerships
Disease
Plan Design Build Operate Operator
Management
Organization
Technology
Cost / Economics
Leadership
Governance &
Accountability
(Simplified for illustrative purposes)

8. DMOs has potential to change the patient pathway (illustrative only)
GP Hospitals Allied Health Polyclinic
Disease
Management
Organization Pharmacies Preventative
Care
KPI: Health Outcomes
Information and technology
DMO Operation
Skilled workforce
Health
Payment / Billing
Medical Devices Information Governance
Services
Infrastructure Exchange
Connectivity
Financing and Health system performance
(Illustrative )

9. Disease management represents a comprehensive, ongoing, and
coordinated approach to achieving desired outcomes for a population of
patients
Roles & Integration with
Responsibilities health plans /
of DMO care Sponsoring
team agency
Coordination:
Patient Care:
Physicians &
Integration of all
Other
Health Outcomes health needs
Practitioners
(KPI)
Patient
Medical Stratification to
Leadership* ensure appropriate
intervention
Disease Management Organization
Asses/
Identification Prevention Promotion Manage Monitor/Analyze
*includes representatives from Primary care physicians, Specialty physicians as appropriate

10. Vision and Guiding Principles of Disease Management Organization
Guiding Principles to Achieve Vision
Person/family – centred • A system that is accessible around the person and their family/caregivers.
• Focuses on collaboration among health service providers while including the individual and
Supportive & Collaborative family in the care team.
• Cultural sensitivity is embedded throughout the future model.
A population that is as
• Refocusing efforts on prevention and health promotion to foster a healthy population.
healthy as possible
• A simplified system and continuum of services that is seamless to the person.
• Easily navigated to enable individuals to move through the system with ease.
• Clear, timely, and transparent communication for all involved members of the circle of care
Coordinated / integrated which may include health service providers (regulated / non-regulated) and people receiving
care.
• A system that has available resources and allows for sharing of resources (i.e. volunteer
management)
• Emphasis on self-management to enable people to “own” and be accountable for their health for
Empowerment those who are able.
• Focus on holistic healing that includes mental, physical, emotional, and spiritual health.
Healthy / integrated healing • A culture/environment which makes it easier to live with a chronic disease by reducing the
burden of disease.
• Focus on care and planning for the future (i.e. targeted towards 2020).
• Accountability is woven throughout system by ensuring that program elements are evidence-
Focus on future (2020) based and outcome-oriented.
• Develop a system that is flexible and adaptable to new technologies.
• Leverage existing resources and don’t reinvent the wheel.

11. Defining the Disease Management Organization - Operating Model
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